10.2.09 Issue #395 Forward This Newsletter To A Colleague


Belle DuCharme CDPMA
Instructor/Consultant
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Tune Up Your Insurance Systems

It is amazing how fast the year can speed by, and as the holidays approach it becomes time to look at the dental insurance systems in your practice. As the contract year for most insurance plans comes to an end and the “use it or lose it” clause is eminent, it is time to gently remind those patients who have benefit dollars remaining and who need dental work done that now is the time to schedule it. For practices that can send email reminders, it is a far easier task than for those offices that have to do a mail merge and send letters. Either way, it is a must do because many patients are too busy to monitor their own benefits. You can include the following letter in recall reminders and in outgoing statements also:

Don’t Forget to Use Your Valuable Dental Insurance Benefits Before the Year’s End!

Dear Patient and Friend,

As the year begins to draw to an end, it is brought to my attention that many people do not realize that their dental plan benefit dollars do not “carry over” into the next year.  In other words, if you don’t use them, you lose them. The cost of dental care benefits is on the rise and it makes sense to use every dollar you’re entitled to. Your employer may opt to purchase a different plan next year which may not have the coverage you have now.

If you have money in a HSA or cafeteria plan that needs to be used, now is the time to schedule an appointment before the end of the year rush. The end of the year is a busy time for us as our appointment book begins to fill, so it is a good idea to call us today to reserve the best time for you. So that you can plan accordingly, the office will be closed the Friday after Thanksgiving and December 23rd to January 4th of next year. 

Now is the best time to take care of your family’s dental health and save money at the same time.

Being proactive all year round will help you to encourage patients to be aware of what their particular plan offers. At each recall appointment, take a look at the existing treatment plan to see if all work has been completed, if there are any pending pre-determinations, or if there are any procedures that the doctor is phasing for future treatment. Educate the patient at the chair and when they are at the desk, so they know what is left to do and how they can use the dollars to their benefit.

In this volatile economy no job is certain, and oftentimes benefits are cut before jobs. Patients appreciate that you want them to get the coverage that is due to them before any change in their economic situation. The key here is to believe in the long term value of good dentistry. If the patient is hedging because of the co-payment, demonstrate the value for the dollar. For instance, if the insurance plan pays 50% of a crown that costs $950 leaving $475 as the co-pay, divide that by the estimated average life of the crown (5 years minimum and 10-20 years for patients with excellent hygiene and periodontal health). That’s $95 a year for a 5 year replacement.  An excellent value considering that you use your teeth every day.

In billing procedures that are cast and will need a return seat date, consider that some plans pay on the prep date and some on the seat. Toward the end of the year, when it is possible to prep a tooth and then have to seat it in January because of the holiday schedule, make sure that you have checked the insurance rule. Don’t gamble on this one, as insurance companies often ask for the prep and seat date and sometimes want to see the clinical notes to verify the dates.

Speed up the payment of claims to keep the cash flow churning by making sure that all information entered on the claims is correct and verified.  E-claims are the best and quickest way to achieve cash turnaround. Know the rule for sending X-rays, as each insurance company has its requirements. In general, major services and periodontal services need supporting evidence and documentation. For paper claims, attach X-rays and periodontal charting if you are not sure if the insurance company wants them or not because of the delay in regular mail. 

Tune up your insurance system now or you will have a break down at the end of the year. For training on how to tune up all of your dental office systems, call today and get enrolled in McKenzie Management’s Front Office Training Program.

If you would like more information on Treatment Acceptance Training to get more patients to say “yes”, email training@mckenziemgmt.com.

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